Otis Optometry, LLC

Optometrist · Camdenton, MO

Organization Active NPI

NPI number 1568873602

Practice location

94 Cecil St
Camdenton, MO 65020-7057
Phone
(573) 317-9279
Fax
(888) 841-1312

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NPI record

NPI
1568873602
Entity type
Organization (Type 2)
Enumeration date
May 12, 2014
Last updated
July 29, 2014
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Optometrist Primary 152W00000X TO3134 MO

Mailing address

1939 Wentzville Pkwy
Ste 166
Wentzville, MO 63385-3424
Phone
(636) 812-3821
Fax
(888) 841-1312

Authorized official

Name
Mr. Matt David Wickham, O.D.
Title
Owner
Phone
(314) 276-1228

About Otis Optometry, LLC

Otis Optometry, LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Optometrist (code 152W00000X). The practice location is 94 Cecil St, Camdenton, MO 65020-7057. The NPI number 1568873602 was assigned on May 12, 2014 and the record was last updated on July 29, 2014.

Otis Optometry, LLC lists a license in the registry: #TO3134 (MO) for Optometrist. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Mr. Matt David Wickham, O.D., Owner.

Frequently asked questions

What is the NPI number of Otis Optometry, LLC?

The NPI number is 1568873602.

What is the phone number of Otis Optometry, LLC?

The phone number listed for the practice location is (573) 317-9279.

Where is Otis Optometry, LLC located?

94 Cecil St, Camdenton, MO 65020-7057.

What is the taxonomy code for Otis Optometry, LLC?

The primary taxonomy code is 152W00000X – Optometrist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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